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Gout Tophi Treatments

Gout is a arthritic disease that can develop when excess amounts of uric acid are present in the body. It is characterized by the formation of uric crystals in the linings of affected joints. In its advanced stages the condition may be accompanied by the formation of tophi, or masses of monosodium urate crystals, in the body's soft tissues. Treatment for gout tophi involves the use of medications to diminish the presence of uric acid.

  1. Understanding Gout Tophi

    • Gout tophi are a component of chronic gout, and typically develop within 10 to 12 years of the onset of symptoms. In rare cases, it may also develop from short-term acute gout. The most commonly affected sites in the body include the base of the big toe, elbows, fingers, wrists, hands and Achilles tendon. If you develop gout tophi, your symptoms may include pain, joint destruction and deformation, soft tissue damage and nerve compression. Report these signs to your doctor if they occur.

    Determining Proper Treatment

    • If you are diagnosed with gout tophi, your treatment will focus on eliminating excess uric acid. In order to achieve this goal, your doctor will first need to discover what is causing your uric acid buildup. In some cases, your body produces uric acid at an accelerated rate. In other cases, your kidneys are unable to eliminate normal amounts of uric acid from the blood. Once your doctor finds out which of these processes is present, he will make his treatment choice.

    Treatment With Allopurinal

    • If you produce too much uric acid, your doctor will probably use a medication called allopurinal (Aloprim, Zyloprim), which disrupts the conversion of certain key chemicals into uric acid. Allopurinal is effective, and is the most widely used option in treating gout tophi. The intensity of its effects varies with the dosage given, and your doctor will attempt to match your treatment to the amount of excess uric acid in your system. Potential side effects of allopurinal include lowered blood counts, gastrointestinal distress and skin rash. At the beginning of treatment, you are also at risk for an attack of acute gout. Talk to your doctor as soon as possible if you experience these side effects.

    Treatment With Probenecid

    • Allopurinal is also effective in cases where low uric acid elimination is present, but your doctor may also prescribe a class of medications called uricosurics, which act directly on the kidneys to improve their eliminative function. The most commonly prescribed form of uricosuric is called probenecid (Benemid); if your doctor prefers this medication you will typically be given a 1 to 2 gram dose daily. Potential serious side effects of probenecid use include shortness of breath, swelling around the eyes, skin rash and changes in skin color. If you experience any of these symptoms, contact your doctor immediately. Less serious side effects include difficulty urinating, bloody or cloudy urine and pain in the lower back or sides. Consult your doctor as soon as possible if these symptoms occur. Probenecid may also cause kidney stone formation, and should not be used if kidney stones are already present.

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